Let’s Talk About MIPS for PTs, OTs, and SLPs

This year, the CMS is making some drastic changes. They’re introducing the Merit-Based Incentive Payment System (MIPS) for PTs, OTs, and SLPS. In this article, we’ll divulge everything we know about it.


MIPS seeks to consolidate the Meaningful Use (MU), the Value Based Payment Modifier (VM), and the Physician Quality Reporting System (PQRS) of old. In doing so, they’re hoping help rehabilitation healthcare providers focus on a quality-based means of compensation.


Healthcare providers will not be required to participate in MIPS for the 2017 calendar year. And while it’s been mentioned that providers will have an opportunity to enrol in a trial of MIPS, the CMS has been uncharacteristically quiet about how to do so.


The MIPS system is said to have come into effect January 1, 2017, but as mentioned above, healthcare providers haven’t received clear instructions on how to participate. But what we do know is that payment adjustments on Medicare Part B payments will not begin until 2019. The CMS website states that the providers who participate will “earn a payment adjustment based on evidence-based and practice-specific quality data.”


Overall, MIPS is comprised of four unique parts: ‘Quality’ replaces PQRS, ‘Advancing Care Information’ replaces MU, ‘Cost’ replaces VM, and they’re adding an entirely new section called ‘Improvement Activities’. These categories will be combined to determine the healthcare providers MIPS score, and the adjustment will be applied to the provider’s Medicare Part B payments 2 calendars later.


Click here to read our article about the demise of PQRS, and its newest incarnation. 


Knowing that MIPS has a direct impact on the earning potential of a clinic explains why so many of them are trying to get ahead of the curve and voluntarily participate, despite not being required to participate for at least another year. Furthermore, many PTs, OTs, and SLPs user their EMR software to keep track of these important measurements, so they’re looking to us to help them get organized.


Bear in mind that this is merely a preview of what’s to come. We encourage you to spend some time researching MIPS on the CMS website, and stay tuned to our blog for any software updates pertaining to it.